Cardiology Flashcards
Rise and fall of cardiac enzymes
Myoglobin rises 1-4 hours after onset (first to rise)
CK-MB and troponin rise 3-6 hours after onset
CK-MB falls 1-2 days after (check this for re-infarction)
Troponin falls 1-2 weeks later
What is Sestamibi testing?
Nuclear stress test on obese patients or ones with large breasts. Radioisotope with better penetration.
Initial treatment of ACS? Why?
Aspirin. Immediate platelet inhibition and reduces mortality 25% (MI) or 50% (unstable angina)
ACS medications that lower mortality
STOP-ACs
Statins, Thrombolytics, metOprOlOl, PCI, Aspirin, Clopidogrel
When are CCB favoured over BB?
When patient has asthma, cocaine-induced CP or primzmetal’s angina
When do you give lidocaine or amiodarone for MI?
Only with VTach or VFib
How long to wait after MI before resuming stressful activities?
2-6 weeks
Anticoagulant to use with NSTEMI
LMWH (Lovenox) - favoured over IV heparin
Side effect of ACEI/ARB seen on EKG?
Hyperkalemia
Indications for CABG
3 vessel disease OR left main CA with >70% stenosis
Statin goal for 1)ACS and 2)diabetes
ACS: LDL<70
Most common SE of statin therapy?
Liver toxicity
Standard of Care for acute pulm. edema?
Oxygen, nitrates, furosemide, morphine
How long before stress testing do you hold BB?
24-48hrs
Beta Blocker to avoid during pregnancy?
Atenolol (small size, early delivery, low weight)
